Targeted acupuncture may offer women with major depression a safe and effective alternative to antidepressant medication, new research suggests.

Investigators at Stanford University School of Medicine in California found that women with major depressive disorder treated with depression-specific acupuncture had a 63% response rate after 12 sessions compared with a 44.3% response rate in 2 combined control groups who were treated with either acupuncture not known to help alleviate depressive symptoms or Swedish massage.

"Pregnancy just by its nature can bring out some underlying psychiatric and emotional issues ... but treatment of depression during pregnancy is critically important so that a woman can maintain her sense of well being and take good care of herself, her fetus and, someday, her child," study coauthor Deirdre Lyell, MD, Stanford University School of Medicine, said in a statement.

Led by Rachel Manber, PhD, the study was published in the March issue of Obstetrics & Gynecology.

Response Rates Significantly Higher

For the study, investigators randomized 150 women whose pregnancies were between 12 and 30 weeks of gestation and who met Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for major depressive disorder and who scored at least 14 on the 17-item Hamilton Rating Scale for Depression.

Of the 141 women who eventually entered the study, 52 received depression-specific acupuncture, 49 received control acupuncture, and 49 others received Swedish massage.

Treatments were provided twice a week for the first 4 weeks and then weekly thereafter for 4 additional weeks, with each session lasting about 25 minutes.

The investigators found that response rates were significantly higher in women who received depression-specific acupuncture than for either control group. Response rates in women randomized to the 2 control interventions did not differ significantly from each other at 37.5% for the control acupuncture group vs 50% for the massage group.

On the other hand, remission rates did not differ significantly between women who received depression-specific acupuncture at 34.8% and the combined control groups at 29.5%. They also did not differ between those assigned to the control acupuncture group at 27.5% or the massage group at 31.2%.

Thirty-three of the study participants discontinued treatment before the study endpoint, 30% of them for reasons related to the pregnancy. Some women in both acupuncture groups reported transient discomfort at the point of needle insertion, and 1 woman experienced bleeding at the needle site.

Significantly fewer women who received massage reported any adverse effects compared with the 2 acupuncture groups.

Clinically Meaningful

The study authors point out that the benefits observed with depression-specific acupuncture can be considered "clinically meaningful" when assessed in a broader context of depression studies.

Although there are no randomized controlled trials of antidepressants being used during pregnancy, 1 randomized controlled trial found that interpersonal psychotherapy produced a 52% reduction in Hamilton Rating Scale for Depression scores and a 19% remission rate after 16 weeks of therapy, to which the currently study compares very favorably.

According to the study, antidepressant use during pregnancy doubled between 1999 and 2003, but many women are reluctant to take these medications because of safety concerns. In fact, in this particular study, 94% of the women involved expressed reluctance to take an antidepressant because of their pregnancy.

"Because theres this concern about medication among pregnant women and their physicians, its important to find an alternative," said Dr. Manber.

Results from this study therefore suggest that this standardized acupuncture protocol could be considered a "viable treatment option" for depression during pregnancy, the investigators conclude.

Michael Thase, MD, University of Pennsylvania School of Medicine, cautions that findings from this study are preliminary, although they suggest that depression-specific acupuncture may have value in major depressive disorder in this patient population.

On the other hand, another study assessing depression-specific acupuncture in a broader population of men and women with major depressive disorder failed to find a significant effect from the modality, so evidence supporting acupuncture for the treatment of major depressive disorder is not consistent.

"Still there is reason to be cautious when prescribing antidepressants in pregnancy, and one has to weigh the pros and cons of using an antidepressant on an individual basis, he told Medscape Psychiatry.

"If these promising findings are confirmed, it would be good to have another option to complement the focused forms of psychotherapy which are currently used for antenatal depression," he added.

The study was funded by the Agency for Healthcare Research and Quality. The study authors and Dr. Thase have disclosed no relevant financial relationships.

In the 1992 presidential
campaign, Bill Clinton was a heavy underdog to popular incumbent George H. W.
Bush. Bush was considered unbeatable due to foreign policy successes including
the end of the Cold War and routing Saddam Hussein in the first Gulf War. But
Bushs approval ratings, which had been in the 90 percent range, began to dip as
his campaign ignored the economic recession. Clintons campaign manager James
Carvilles now famous campaign slogan, "Its the economy stupid," helped turn
the tide and Bill Clinton became the forty-second American president.

Just like George Bushs 1992
presidential campaign, todays medical community continues to promote the
medical myths associated with cholesterol while ignoring the real cause of
cardiovascular disease, inflammation.

Conventional opinion and
current medical dogma holds that low cholesterol, especially low LDL
cholesterol, reduces the risk and incidence of heart disease and stroke. This
belief is so entrenched in the medical community that the FDA now approves drugs
to prevent heart disease, as it did with Zetia and Vytorin, solely on the
evidence that they lower LDL cholesterol levels. Zetia has never been proven to
reduce heart attacks, strokes or death. Statin drugs help reduce the risk of
heart attack and stroke for those whove already had a cardiac event (one
percent over placebo) but fail to reduce death in women, the elderly, men over
the age of 47, and in men without cardiovascular risk factors.

A 2006 study in The
Archives of Internal Medicine looked at seven trials of statin use in
nearly 43,000 patients, mostly middle-aged men without heart disease. In that
review, statins didnt lower mortality.

Nor did they in a study known
as Prosper, published in The Lancet in 2002, which studied statin use
in people seventy and older. Nor did they in a 2004 review in The Journal of
the American Medical Association, which looked at thirteen studies of
nearly 20,000 women, both healthy and with established heart disease.

Despite a growing voice of
reason, which became even louder after the recently released Enhance study, the
cholesterol zealots continue to view cardiovascular disease with tunnel vision.
This myopic vision fuels the cholesterol drug war which rages on as each
pharmaceutical company seeks to gain economic gain in the 40 billion dollar a
year lipid lowering drug market.

In an attempt to take on the
cholesterol Goliath, Pfizers Lipitor (10 billion dollars in sales annually),
Merck and Schering-Plough combined their cholesterol lowering drugs, Zocor and
Zetia, to form the "super drug" known as Vytorin. Vytorins goal was to lower
LDL cholesterol more than either drug could alone. Zetia lowers blood
cholesterol by blocking the absorption of dietary cholesterol from the
intestines. Zetia used alone is modestly effective in lowering LDL cholesterol
by approximately 17 percent. Zocor alone lowers LDL levels by 36 percentsimilar
to Lipitor.

The hope was that by lowering
LDL to dramatically low levels, Vytorin would do a better job of slowing the
accumulation of fatty plaques in the arteries. Vytorin did, in fact, reduce
LDLby a whopping 51 percent (similar to AstraZenecas Crestor).

However, the two-year
"Enhance" trial failed to prove that Vytorin is better than Zocor alone for
slowing plaque accumulation; instead atherosclerosis worsened in those taking
Vytorin.

Merck and Schering-Plough
suppressed this finding for twenty months.

The study results were not
revealed until the two drug companies were pressured into doing so by an article
in The New York Times and a Congressional inquiry. The marketers of
Vytorin said they had nothing to hide. Its hard to believe they werent just a
little reluctant to publish their highly anticipated study. The news that
Vytorin, which retails for $100 a month and did $2 billion in sales in 2007, was
clinically inferior (perhaps even dangerous) to generic simvastatin (statin),
costing less than $20 a month, obviously wasnt what stockholders wanted to
hear.

Merck and Schering-Plough are
running full-page ads daily in the Times and Wall Street
Journal, warning people not to be confused by a single study and to
continue taking Vytorin. The advice was backed by the American Heart
Association, which the Times reported receives nearly $2 million a year
from Merck/Schering-Plough Pharmaceuticals.

Other LDL lowering drugs have
bitten the dust in the last coupe of years as well.

Pfizers trial of its
much-anticipated drug torcetrapib, which raised HDL, the good cholesterol, and
lowered LDL, had to be stopped in 2006 because the drug caused heart attacks and
strokes.

Estrogen replacement therapy,
which is known to lower LDL cholesterol levels, failed to reduce the incidence
of heart attack and stroke in clinical studies.

Ok, if cholesterol lowering
isnt the answer for everyone, why do statins help people with existing heart
disease? Dr. James K. Liao of Brigham & Womens Hospital in Cambridge,
Massachusetts, has been investigating this question for over a decade. He
suspects that statins have other biological effects. His research shows that
statin drugs not only block cholesterol, but also an inflammation-generating
enzyme known as rho-kinase.

When Liao reduced the
rho-kinase levels in rats, they didnt get heart disease. "Cholesterol lowering
is not the reason for the benefit of statins," he concludes. Of course, there
are dozens of inflammatory chemicals that play a role in triggering
cardiovascular disease. Diet, health habits, our environment, even our
personality may initiate inflammatory chemicals that perpetuate cardiovascular
disease events.

Ralph Waldo Emerson once said,
"People see only what they are prepared to see." As the evidence about
inflammation and cardiovascular disease rises, will conventional medicine and
the public at large be prepared to see that its not about lowering cholesterol
but in reducing inflammation? Hopefully, "Its the inflammation, stupid," will
become a common slogan in the campaign to fight cardiovascular disease.

Rodger Murphree, D.C., has
been in private practice since 1990. He is the founder of, and past clinic
director for a large integrated medical practice, which was located on the
campus of Brookwood Hospital in Birmingham, Alabama. He is the author of
Treating and Beating Fibromyalgia
and Chronic Fatigue Syndrome, Heart Disease What Your Doctor Wont Tell You,
and Treating and Beating Anxiety and Depression with Orthomolecular
Medicine. He can be reached at www.treatingandbeating.com, by email at
drrodgerm@yahoo.com or 1-205-879-2383.

LIVE LOVE LAUGHEvery day can be filled with meaning. Take a moment, just the amount of time you need to take a deep breath and exhale slowly, to ask yourself what is my dream, and how will I get there from here?What can you stop doing or do differently to simplify your life and make it more meaningful? What is truly important to you? Do you give some time each week to your true priorities?Why not fill your life with love and laughter whenever you can? There is no greater gift than the gift of loving others. There is nothing wrong with taking some time for self-care too. Love your pet? Love walking out in nature? Make time for your passions and those things that add value to your life. Your body, mind and soul will thank you.Do you have a mission in life?Dream it. Think about it. Talk about it. Commit to it.

New research again confirms the motion benefits of chiropractic care. In a recent study, researchers found that chiropractic manipulation of the cervical spine (neck) resulted in an increased motion and improved performance of the cervical spine. These improvements were recorded after just one cervical adjustment. So how does all this work? Chiropractic manipulations / adjustments not only introduce motion into the joints, they positively stimulate the nervous system related to those joints. This gentle and skillfully applied motion, whether through the hands or use of an instrument, and nervous system activation results in the movement of nourishing fluid into the joint, a reduction in joint adhesions as well as an activation in the nerves surrounding the joints. All in all, this has been shown to reduce inflammation, reduce pain, and as this study has shown, improve motion and overall joint performance.

A recent Norway study indicates that in both men and women obesity is strongly associated with chronic low back pain. The increased weight of being obese wreaks havoc on the spinal tissues that are placed under constant and increased stress due to the additional weight. Fortunately, most obesity is treatable and with loss of the additional weight, many experience significant improvements in their back pain complaints, not to mention the improvement or reversal of many other related health conditions. Fortunately, chiropractic care can still help before the additional weight comes off, or, if the additional weight cannot be lost. Chiropractors not only provide relief for many experiencing back pain due to obesity, but some additionally offer treatment programs directed at weight loss and strategies to improve ones overall health. If youve got extra pounds to lose and are suffering from back problems, you deserve an opportunity to try chiropractic care!

Limited physical activity is one of the main health concerns for the elderly. The National Institutes of Health report that moderate exercise and physical activity can improve the health of seniors who are frail, or who have diseases associated with aging. However, exercise alone wont necessarily address the spinal problems which seniors commonly experience. This is a concern as spinal problems can cause pain and subsequent decline in physical function in older adults. A new study being conducted at the Wolfe-Harris Center for Clinical Studies at Northwestern Health Sciences University is examining how exercise and chiropractic care can impact the overall health and spinal function of seniors. The University received nearly $1.6 million in federal funding from the U.S. Health Resources and Services Administration (HRSA) to conduct the study. The study is a randomized clinical trial which will assess the combination of chiropractic management and exercise therapy. Participants must be 65 years of age and older with chronic spine problems. The study is unique in that it is one of the first to assess the effects of long-term chiropractic management on disability, pain, functional capacity, and balance in seniors The study will also measure differences between groups in patient-reported general health, improvement, and medication use. Recruitment for the study began at the beginning of 2010, and will continue for the next three years. The study will significantly contribute to the evidence base of conservative, non-drug treatments that address disability and pain in seniors with spinal problems. According to Michele Maiers, DC, associate dean of research and knowledge transfer at Northwestern, Identifying effective therapies has tremendous potential to substantially improve the function, quality of life and overall health of the aging population. The study is aligned with the Healthy People 2010 goals of reducing activity limitation due to chronic back conditions, as well as increasing physical activity and fitness in adults.

A record-breaking settlement has been reached between the American Medical Association, et al. and UnitedHealth Group - the nations largest health insurer - for 15 years of artificially low payments for out-of-network services. More than $350 million has been allocated to compensate impacted providers and subscribers, including doctors of chiropractic and their patients, according to the American Chiropractic Association (ACA). Affected providers and subscribers should have received mailings from UnitedHealth Group that include an overview of the settlement, instructions for filing a claim for payment and proof of claim forms. Claims for payment must be filed by Oct. 5, 2010. Anyone filing objections to the settlement or opting out of the settlement must do so by July 27, 2010. Evidence of UnitedHealth Groups improper business practices was confirmed after an investigation by New York Attorney General Andrew Cuomo over allegations that a database operated by Ingenix, Inc., a wholly-owned subsidiary of UnitedHealth Group, intentionally skewed usual and customary rates downward through faulty data collection, poor pooling procedures and the lack of audits. The Attorney General found that having a health insurer determine the usual and customary rate  a large portion of which the insurer then reimburses  creates an incentive for the insurer to manipulate the rate downward. The creation of a new database, independently maintained by a nonprofit organization, is designed to remove this conflict of interest. The settlement will be finalized at the United States Courthouse, United States District for the Southern District of New York on Sept. 13, 2010. For more information about this settlement, the New York State Attorney General has made background information about the investigation and the settlement available online. In addition, Berdon Claims Administration LLC and the American Medical Association (AMA) have answers to frequently asked questions, detailed next steps and links to more information on their Web sites. Finally, AMA has developed a step-by-step guide for providers who are looking to maximize their recovery from the settlement. ACA urges anyone with legal questions about the settlement to consult a local attorney. ACA cannot provide legal advice. ACA is the largest chiropractic organization in the United States, representing the interests of more than 15,000 doctors of chiropractic and their patients.